California Department of Public Health - Vital Records · California state form
VS 112 SP Application for Certified Copy of Death Record
Use VS 112 SP to request an authorized or informational certified copy of a California death record from the Department of Public Health, Vital Records.
- What this form is
- This application asks for information about the deceased person, the applicant, and the applicant’s relationship to the person named on the death record. Applicants may request an authorized copy, available only to people listed as eligible, or an informational copy. The form instructions explain what to include with the application and how to submit it to California Department of Public Health, Vital Records.
- Who needs it
- People requesting an authorized or informational certified copy of a death record held by California Department of Public Health, Vital Records.
- Why it needs a notary
- An authorized-copy request requires a notarized sworn statement, except for listed exempt applicants. This signature can be notarized online with a commissioned online notary. Informational-copy requests do not need notarization.
- How to submit it
- Complete the application and send it with the required payment to California Department of Public Health, Vital Records, MS 5103, P.O. Box 997410, Sacramento, CA 95899-7410. Do not send cash.
Questions
Who can request an authorized copy of a death record?
The form lists eligible people, including certain relatives, government representatives, attorneys, and others authorized to act for the person or estate. Other applicants may request an informational copy.
Does the VS 112 SP application need to be notarized?
An authorized-copy request generally requires the attached sworn statement to be notarized. The form lists exemptions for certain applicants. Informational-copy requests do not require a sworn statement.
How do I submit the VS 112 SP application?
Mail the completed application and required payment to California Department of Public Health, Vital Records, MS 5103, P.O. Box 997410, Sacramento, CA 95899-7410. The instructions say not to send cash.